Curbside Consultation in Endoscopy: 49 Clinical Questions, Second Edition

Joseph Leung, MD; Simon Lo, MD

Question 10: Several Trips To The Er For A 56-Year-Old Mechanic For Sob And Iron Deficient Anemia Revealed Positive Fobt, But Egd And Colonoscopies Did Not Identify The Bleeding Source. He Takes Nsaids Regularly For Arthritis Pain. Is There A Role For Enteroscopy? (continued)

Neel K. Mann, MD, MPH

This is a classic description of symptomatic obscure–occult gastrointestinal (GI) bleed. The patient is a gentleman with persistent anemia, and the GI tract is the suspected source of bleeding despite prior negative but appropriate endoscopy. This case of obscure GI bleeding can be further categorized into an obscure–occult GI bleed because there are no overt signs of GI bleeding, although the patient is dependent upon iron supplementation. The usual approach in the diagnostic algorithm1 of an obscure GI bleed would be a second-look endoscopy, as up to 12% to 25%…